Teachability of lower cervical spine injury classifications

Objectives

To compare the teachability of the Allen–Ferguson, Harris, Argenson, AOSpine, Subaxial Cervical Spine Injury Classification (SLIC), Subaxial Cervical Spine Injury Classification (CSISS) and to identify the classification that a group of residents and junior neurosurgeons find easiest to learn.

Methods

We used data from 64 consecutive patients. Answers of nine residents and junior neurosurgeons and four experienced surgeons in two assessment procedures were used. Six raters (workshop group) participated in special seminars between assessments. Three other raters formed the control group. Experienced surgeon's answers were used for comparison. Teachability was measured as the median value of the difference (ΔK) in the interrater agreement on the same patients by the same pairs of subjects.

Results

Median Δ K for the Allen–Ferguson, Harris, Argenson and AOSpine classifications were: (1) 0.01, 0.02, 0.29, and 0.39 for the workshop group; (2). 0.09, −0.03, 0.06 and 0.04 for the control group, respectively. Between numerical scales, median ΔK was higher for SLIC but did not exceed 0.16. Interrater consistency with expert's opinion was increased in the workshop group for Allen–Ferguson, Argenson and AOSpine and did not differ in either group for SLIC and CSISS.

Conclusion

The AOSpine classification was the most teachable. Among numeric scales, SLIC demonstrated better results. The successful application of these classifications by residents and junior neurosurgeons was possible after a short educational course. The use of these scales in educational cycles at the stage of residency can significantly simplify the communication between specialists, especially at the stage of patient admission.